Rectal bleeding; Blood in the stool; Hematochezia; Lower gastrointestinal bleeding
Rectal bleeding is when blood passes from the rectum or anus. Bleeding may be noted on the stool or be seen as blood on toilet paper or in the toilet. The blood may be bright red. The term "hematochezia" is used to describe this finding.
The color of the blood in the stools may indicate the source of bleeding.
Black or tarry stools may be due to bleeding in the upper part of the GI (gastrointestinal) tract, such as the esophagus, stomach, or the first part of the small intestine. In this case, blood is most often darker because it gets digested on its way through the GI tract. Much less commonly, this type bleeding can be brisk enough to present with bright rectal bleeding.
With rectal bleeding, the blood is red or fresh. This usually means that the source of bleeding is the lower GI tract (colon and rectum).
Eating beets or foods with red food coloring can sometimes make stools appear reddish. In these cases, your doctor can test the stool with a chemical to rule out the presence of blood.
Rectal bleeding causes include:
Contact your health care provider if there is:
You should see your provider and have an exam, even if you think that hemorrhoids are causing the blood in your stool.
In children, a small amount of blood in the stool is most often not serious. The most common cause is constipation. You should still tell your child's provider if you notice this problem.
Your provider will take a medical history and perform a physical exam. The exam will focus on your abdomen and rectum.
You may be asked the following questions:
You may need to have one or more imaging tests to look for the cause:
You may have one or more lab tests before, including:
Kaplan GG, Ng SC. Epidemiology, pathogenesis, and diagnosis of inflammatory bowel diseases. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 115.
Kwaan MR. Hemorrhoids, anal fissure, and anorectal abscess and fistula. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2020. Philadelphia, PA: Elsevier; 2020:222-226.
Lamps LW. Anus. In: Goldblum JR, Lamps LW, McKenney JK, Myers JL, eds. Rosai and Ackerman's Surgical Pathology. 11th ed. Philadelphia, PA: Elsevier; 2018:chap 18.
Meguerdichian DA, Goralnick E. Gastrointestinal bleeding. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 27.
Swartz MH. The abdomen. In: Swartz MH, ed. Textbook of Physical Diagnosis: History and Examination. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 17.BACK TO TOP
Review Date: 4/13/2020
Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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